Probiotic reduces risk of infections for preschoolers

NEW YORK (Reuters Health) - A trial in Mexico suggests
probiotics may help protect kids from the mild, but seemingly
constant, illnesses they pick up in daycare.

Preschoolers given a daily probiotic for three months had
markedly fewer respiratory infections and bouts of diarrhea
compared to classmates taking a placebo, according to the trial
results published in Pediatrics.

Dr. Pedro Gutierrez-Castrellon, who led the study, said
probiotics are a promising line of research in the field of
pediatric preventive medicine.

Children in daycare centers are at increased risk of both
gastrointestinal and respiratory illness. Probiotics are
"friendly" bacteria thought to benefit the immune system and
digestion.

Often available over the counter, probiotics can come in
capsules, drops or incorporated into foods like yogurt.

For the study, Gutierrez-Castrellon, a researcher with the
National Perinatology Institute in Mexico City, and his
colleagues tested a friendly-bacteria strain called
Lactobacillus reuteri DSM 17938 in four daycare centers in
Mexico City.

"When we analyzed the field of probiotics in pediatrics, we
identify L. reuteri as one of the strongest type of probiotics
for use in children," Gutierrez-Castrellon said.

He added that it's better to use a single strain of
probiotic bacteria than multiple strains, so they focused their
study on L. reuteri.

Gutierrez-Castrellon and colleagues enrolled a total of 336
children ages six months to three years in the study and
followed each child for six months.

Half the children were given eight probiotic drops daily for
three months, while the other half were given a placebo
treatment - identical drops containing no probiotics.

Parents and caregivers recorded any episodes of diarrhea or
respiratory symptoms for the three months the children were
given the drops and for the three months after the drops were
discontinued.

During the first three months, there were a total of 42
episodes of diarrhea with an average duration of 1.4 days among
kids who got the probiotics. The children in the placebo group
had 69 diarrhea episodes that lasted, on average, 2.5 days.

Respiratory tract symptoms totaled 93 reports among kids in
the probiotic group compared to 204 reports in the placebo
group.

The differences in illness rates endured after the children
stopped taking the probiotics. During the three-month follow-up,
there were 57 reports of diarrhea in the treatment group
compared to 83 in the placebo group and 129 reports of
respiratory symptoms compared to 197 in the placebo group.

The researchers also found the children in the treatment
group used antibiotics less during the study. When they
calculated the total costs of illnesses, including medical
visits, rehydration solutions and all types of drug treatments,
they linked probiotic use to cost savings of $36 per episode of
diarrhea and $37 per case of respiratory tract infection.

The study was funded by BioGaia AB, Stockholm, Sweden, which
also provided the L. reuteri probiotic used in the research.

Roger Clemens told Reuters Health the study validates and
reinforces previous studies on probiotic use in young children.

"I think this is critical from a public health perspective
in daycare centers where we have a high increase of diarrheal
disease because kids pass everything around," he said. "The kids
go to daycare centers and bring it home and mom and dad get sick
- so they share that a lot."

Clemens, who was not involved in the study, is a researcher
and associate director of the regulatory science program at the
University of Southern California School of Pharmacy in Los
Angeles.

He added that studying specific strains of probiotics at
specific doses for specific outcomes is important, and he
believes L. reuteri is a potent strain of probiotic.

"If you take it on a regular basis you can reduce the risk
of all kinds of conditions that can happen in the GI tract as
well - it's pretty powerful," he said.

With the large number of probiotics available, it's
difficult for parents to know which probiotics to use without
doing a little research.

Clemens said that pharmacists should know which probiotics
are best, but that parents can also read labels on the products
for additional information.

SOURCE: http://bit.ly/1fJyr2s Pediatrics, online March 17,
2014.

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